OBJECTIVE: To observe the ocular vestibular evoked myogenic potential (oVEMP) and the cervical vestibular evoked myogenic potential (cVEMP) in patients with vestibular diseases. METHOD: From March, 2011 to March, 2012, 13 patients (14 ears) with peripheral vestibular diseases were recruited. Each patient underwent conventional oVEMP and cVEMP examinations elicited by intensive air conducted sound (short tone burst, 500 Hz) in bilateral ears. RESULT: Thirteen cases (14 ears) were included in this study. They were 3 cases (3 ears) with Ramsay Hunt syndrome, 3 cases (4 ears) with acoustic neuroma, 1 case (1 ear) with VII and VIII cranial nerve trauma after head injury, 2 cases (2 ears) with vestibular neuritis, 3 cases (3 ears) with Meniere's disease, and Icase (1 ear) with unilateral hypoplasia of the internal auditory canal. Altogether, oVEMP could be elicited in only 2 ears (14. 3%) and cVEMP were found abnormal in 11 ears (78. 6%). CONCLUSION The otolithic vestibular end organs and their input pathways could be examined by cVEMP and oVEMP examinations in patients with peripheral vestibular disorders.
Acoustic Stimulation ; Eye ; Humans ; Meniere Disease ; Neuroma, Acoustic ; Otolithic Membrane ; Vestibular Diseases ; physiopathology ; Vestibular Evoked Myogenic Potentials ; Vestibular Neuronitis ; Vestibule, Labyrinth

Objective To identify the characteristics of the air-conducted ocular vestibular-evoked myogenic potential(oVEMP) in the young normal Chinese subjects.Methods Twenty five normal subjects were recruited for conventional examinations of oVEMP.The subjects were 19 - 45 years of age [ (24.3 ± 5.6) years ],12 males and 13 females.500 Hz air-conducted tone burst was employed for examination.The threshold of oVEMP in each ear was examined; patterns of these waves were observed and the normal ranges of the oVEMP waves responded to 100 dBnHL were calculated.Results All subjects were elicited with normal oVEMP N1-P1 waves in both ears.The response rate in these subjects was 100％.The threshold of oVEMP examination was ( 86.6 ± 3.6) dBnHL ( (x) ± s),latency N1 ( 10.1 ± 0.4 ) ms,latency P1 ( 14.7 ±1.2) ms,interval N1-P1 ( 4.5 ± 1.0 ) ms,amplitude ( 7.9 ± 4.4 ) μV.Conclusions Air-conducted oVEMP is a kind of vestibular-ocular reflex respond to intensive sound generated by otolithic vestibular end organs.It is stable in the young normal subjects with minor variabilities.

1) Afghanistan is one of countries facing serious health situation in the world, and Japan starts support in various area after Tokyo international conference for Afghanistan reconstruction in January, 2002.
2) International Research Center for Medical Education (IRCME), the University of Tokyo, sent faculties as members of JICA expert team for Kabul in 2003 and 2004, and launched support reconstruction of medical education of Afghanistan.
3) IRCME formed consortium in cooperation with Japan Society for Medical Education, International Medical Center of Japan Bureau of International Cooperation and other institutions in order to carry out Medical Education Project to support medical education development of Kabul Medical University, Afghanistan.

A clinical clerkship program was introduced at the University of Tokyo in 2002 to help students acquire clinical knowledge, skills, and attitudes by increasing their involvement in clinical activities. We assessed the learning effectiveness of clinical clerkships at the University of Tokyo Hospital by examining evaluations of student's clinical competence by themselves and by the faculty. Methods: We evaluated each clerkship with reference to overall educational goals developed in advance. We measured students' self-evaluations and evaluatio s by the faculty before and after the clerkship. Results: At the end of the 2-month clerkship, students' self-evaluation scores (3.18) were significantly higher than before the clerkship (2.71). In particular, scores for patient care were markedly higher. Evaluation scores by the faculty were also higher during (3.64) and after (3.57) clerkships than before (3.26) clerkships. Conclusion: We will use this data to make next year's clerkship programs more effective. We should also develop more-objective strategies for evaluation and establish relevant educational goals.

The purpose of this study was to evaluate the clinical clerkship program at the University of Tokyo Hospital. We report results of course and faculty evaluations by students and of qualitative evaluations, such as students, free comments and group interviews. Methods: Each item of the course and faculty evaluations was related to the overall educational goals developed in advance. Students evaluated the course and faculty immediately after the course ended. Results: Students rated the clerkship program favorably overall, but the scores of thesecond month (3.38) were lower that those of the first month (3.63). Although learning basic clinical procedures is not the main educational goal of the clerkship, students varied widely in their opportunities to perform procedures. Scores of faculty evaluations ranged from 2.93 to 3.87 in the first month and were lower in the second month for all but two items. Interviews revealed that students had fewer learning experiences in the second month because new residents started their rotations at that time. Conclusion: The results suggest that the scheduling of clinical clerkships should be changed. The contents of clerkship need further consideration.

We conducted a national survey to examine the status of programs to teach evidence-based medicine (EBM) to undergraduates in Japan. Our survey specifically focused on four areas: 1) recognition of a need to teach EBM, 2) the present status of programs to teach EBM to undergraduates, 3) details of the timing of existing EBM teaching programs and of departments responsible for it. Sixty-four schools (80%) responded. Nearly all respondents agreed that EBM should be taught, and most agreed that it should be taught both before and after graduation. Most respondents stated that departments must collaborate when preparing to teach EBM. At the time of the survey, 22 medical schools (34%) had already started programs to teach EBM and 28 (42%) were planning to do so. Existing programs mainly targeted 4th-year students, but the department responsible for the programs varied among schools. Further evaluation of the effectiveness of existing programs is now needed.

We conducted a nationwide survey in 2000 regarding undergraduate medical education in Evidence-based Medicine (EBM) in Japan. We asked faculty members responsible for medical education at each medical school 1) whether there are any barriers to teaching EBM, 2) what these barriers are, and 3) what educational resources are needed to overcome them. Responses were received from 64 schools (80%). More than half of the respondents reported barriers to teaching EBM. We identified two kinds of barriers: before EBM is introduced, skepticism toward the concept of EBM and the value of teaching EBM is encountered; later, problems of organizing a curriculum and shortages of staff and materials are encountered. To overcome these barriers, we need: 1) to establish organizations for coordinating educational programs among medical schools, 2) to hold seminars for faculty development, 3) to develop EBM curricula and teaching materials, and 4) to provide computer facilities and appropriate networks.

The clinical competence needed by every beginning resident and the present status of such competencewere examined in August 1998 through questionnaires distributed to clinical educators and the nursing staff of university hospitals and clinical training hospitals designated by the Ministry of Health and Welfare. Completed questionnaires were returned by 576 (65.9%) of clinical educators and nursing staff. With a cluster analysis of the necessity and the present status of clinical competence, 21 items for clinical competence were identified as those most requiring evaluation by the national examination. These 21 items included 11 items for clinical competence in the cognitive domain, 8 items in the psychomotor domain, and 2 in the affective domain. In about half of the direct answers obtained from clinical educators, evaluations were considered necessary for 15 items of clinical competence, of which 13 belonged to the cognitive domain. These results were consistent with the present status. However, practical examinations have also attracted increasing attention, as the results included strong demands that the national examination evaluate some basic clinical skills, such as physical examination and measurement of vital signs. However, about 30 % of authorities governing the national examination thought no changes are needed in the national examination.

This is a report of the 16th Annual Conference on Student Selection held on August 30, 1997 in Tokyo. The main topic of discussion was the subject whether bachelor's degree must be required to medical school applicants. Advantages, disadvantages and expected future problems concerning the proposal by the advisory committee of the Ministry of Education and Culture are widely discussed.

The working group to improve foreign language education in medical schools established in 1994 and chaired by K. Uemura, M.D. sent questionaire about their present curricula and future plans for teaching English to the deans of all 49 public and 31 private medical schools from January 9 to March 9, 1995, and collected the responses from 30 (61.2%) public, 24 (77.4%) private, in total 54 (67.5%) medical schools. The teaching of useful English includes English conversation in 37 (68.5%), medical English in 34 (63.0%), and structures of medical papers in 9 (16.7%) schools. Medical English is also taught as extracurricular and other activities in 40 (74.1%) schools. These figures have increased as compared with the ques-tionaire conducted two years previously. English conversation can be taught to junior (1st & 2nd yrs) students, for whom medical English can only be taught on general medical topics such as the medical care delivery system, bioethics, roles of physicians, and primay care. Therefore medical English is more and more taught to middle-class (3rd & 4th yrs) and senior (5th & 6th yrs) students. It seems necessary to annually conduct a workshop for medical English teachers to improve their strategies of teaching.